At first glance, Iceland’s COVID-19 statistics might seem contradictory. The Nordic island nation, perched in the North Atlantic, has reported more than 500 confirmed cases for every 100,000 people — among the highest rates in the world.
Yet the country has also reported less than 3 deaths per 100,000 people. That compares to more than 27 deaths per 100,000 people in the U.S., and about 23 deaths per 100,000 people in Seattle and King County.
The reason for Iceland’s high case counts and low death rate: widespread and proactive testing. Iceland hasn’t actually had more COVID-19 infections than other countries. But because of aggressive testing, it’s fully aware of the cases it has had.
“We had already been testing for about four weeks when we had the first case,” explained Alma Möller, Iceland’s Director of Health, speaking Thursday during the Nordic Innovation Summit, organized by the National Nordic Museum in Seattle.
The conference, now in its third year, is typically held at the museum in Seattle’s Ballard neighborhood, the city’s longtime Nordic enclave. It took place virtually this year due to global restrictions on travel and public gatherings. But it remained consistent in one of its recurring themes — exploring lessons that the Pacific Northwest can learn from Nordic countries, and vice versa.
Nowhere is that theme more valuable right now than in comparing and contrasting regional and national responses to the pandemic.
Iceland was repeatedly held up as a case study during a panel featuring Möller, along with epidemiologist Kåre Mølbak, executive vice president of the Statens Serum Institut; and Svein Harald Øygard, economist and crisis specialist.
“It’s basically the country in the world that has tested the most, which means that the numbers from Iceland should be the most representative of all,” Øygard said.
Iceland’s size and location work to its advantage in fighting infectious diseases. With 365,000 people, its population is half the city of Seattle, spread over a much larger geography, with hundreds of miles of the Atlantic Ocean separating it from the rest of the Nordic region. It offers publicly funded universal healthcare.
This combination of factors makes Iceland “the perfect laboratory for studying COVID-19,” as Bloomberg News puts it.
But the country’s success in fighting COVID-19 was not happenstance. One key: Iceland had a national pandemic response plan in place, providing clear steps to follow, Möller said during her presentation.
“Our strategy was to ensure that our infrastructure, especially health care, would withstand,” Möller said. “We did that by flattening the curve, by protecting the elderly, by having sufficient PPE (Personal Protective Equipment) and other equipment. And I must say that we never ran out of anything.”
Leaders in the country also focused heavily on informing the public, holding daily press briefings even before the first case was confirmed. Möller described these briefings as “more popular than any soap opera ever seen in Iceland.”
The government also launched a website, covid.is, translated into eight languages, to get the word out to the public.
A partnership with private industry was also key. The country was able to implement widespread testing by working with deCODE Genetics, based in Reykjavik, Iceland.
Iceland also implemented extensive contact tracing, using teams of nurses and police officers to identify and notify people who had come into contact with others diagnosed with COVID-19. Because of this, 57% of all diagnosed cases were among people already in quarantine, Möller said.
The country put early restrictions on nursing homes, and also closed high schools and universities. However, it allowed younger children to continue going to school, with some restrictions, based on the findings from COVID-19 testing. Citing research by deCODE Genetics, Möller said it’s very unlikely that kids infect adults. “Indeed, it’s the other way around.”
Restrictions on schools were lifted on May 4 as part of a broader rollback of protections in the country. Given the typical COVID-19 incubation period, it’s too early to determine the impact of loosening those restrictions, Möller said. However, she added, “we don’t think it will cause another wave.”
As of Thursday, the country reported 12 active COVID-19 cases, none in hospitals.
The next big step will be reopening the country to tourism, one of the key drivers of its economy. Starting on June 15, visitors to Iceland will be offered free COVID-19 testing upon arrival, requiring them to self-isolate for 14 days if positive, or clearing them to travel within the country if negative. Alternatively, they will have the option of presenting a certificate proving they have had a recent negative PCR test for the active virus, or a positive test for antibodies indicating recovery from COVID-19.
The panel was moderated by Birger Steen, chair of the Nordic Innovation Summit, the former Parallels CEO and Microsoft executive, who predicted that the response to COVID-19 in the Nordic countries will be studied by academics, social scientists, economists and others “for years, maybe decades to come.”
Watch a replay of the panel via the video above, or nis2020.com.